EFFECT OF CYTOFLAVIN ON FREQUENCY OF POSTOPERATIVE DELIRIUM AFTER LARGE JOINT REPLACEMENT IN ELDERLY PATIENTS

Background. Postoperative delirium is a common problem in elderly patients undergoing replacement of large joints. The search for means of prevention and treatment of this complication is an urgent task. According to a number of studies, Cytoflavin has antihypoxic properties which can effect the incidence of delirium. Aim. To evaluate the effect of perioperative use of Cytoflavin on the incidence of acute delirium after the hip and knee replacement in patients over 65 years of age. Materials and Methods. The study included 101 patients with coxarthrosis and gonarthrosis. All of them underwent primary knee or hip replacement. Patients were randomized to the study and control groups. In the study group, Cytoflavin was infused prior to surgery and 8 hours after surgery. In the control group, no infusion was performed. As for the rest, the protocol of perio-perative management was identical for both groups. The frequency and severity of postoperative delirium in both groups were studied. Results. In the study group, 5 cases of delirium were observed (10%), and in the control – 6 cases (12%). In all cases, delirium was sedated with dexmedetomidine. Regression of symptoms in both groups was achieved in the morning of the following day. The frequency of development and timing of sedation in groups do not have statistical and clinical significance (p=0.75). Conclusion. It was not possible to identify the difference in the frequency and severity of delirium between the study and the control groups. Thus, Cytoflavin does not affect postoperative delirium after lower limb joint replacement, and other ways of prevention should be found.